Updated NCCN Breast Cancer Screening Guidelines Help Clarify Risk for Patients

The National Comprehensive Cancer Network® (NCCN®) recently published new NCCN Guidelines for Patients®: Breast Cancer Screening and Diagnosis, which helps patients have a clearer understanding of their risk for breast cancer, when they should start screening, and how frequently they should get screened in order to detect the breast cancer earlier, have more treatment options available to them, and have potentially better outcomes from that treatment.

“There are many, often conflicting, recommendations surrounding breast cancer screening, which causes a lot of confusion and apprehension,” said Therese Bevers, MD, professor of clinical cancer prevention at The University of Texas MD Anderson Cancer Center and chair of NCCN Guidelines Panel for Breast Cancer Screening and Diagnosis, in a press release.¹

Resulting from a malignant tumor that has developed from uncontrolled breast cell growth, breast cancer causes more deaths in US women are than any other cancer besides lung cancer. In 2021, it became the most common cancer in the world.² Additionally, in the United States, invasive breast cancer will affect 1 in 8 US women over their lifetime.²

Investigators believe that 85% to 90% of breast cancers result from aging, and only 5% to 10% are genetically inherited from the individual’s parents.² The new guidelines describe the most-commonly observed symptoms for patients to look out for, such as a distinct lump, pain, or nipple discharge. But doctors should also be notified of any unusual changes in the breasts.¹

Additionally, Bevers noted that everyone who has breasts has the potential risk of getting breast cancer.¹

“Most women with average risk should get screened every year beginning at age 40, but if there are additional risk factors present, a provider might recommend an earlier start,” Bevers said in the press release.¹

According to the guidelines, risk assessments should begin for women as early as age 25 years.¹ Additionally, having a family history of ovarian cancer, pancreatic cancer, or other factors can cause an increased risk for patients.¹ For women over the age of 40 years or older who are also pregnant, screening becomes especially pertinent; despite concern regarding the potential harm that could be caused by the screening process, it has low enough radiation to be safe for both the fetus and mother.¹

“Annual mammography screening beginning at age 40 is associated with the highest mortality reduction for average risk women,” said Mark Helvie, MD, professor and active emeritus, Department of Radiology, University of Michigan; Member, NCCN Guidelines Panel for Breast Cancer Screening and Diagnosis, in the press release.¹ “Regular screening and breast exams help find breast cancer at its earliest, most treatable stages. Having a mammogram at infrequent or irregular intervals limits its effectiveness. For women at increased risk, the NCCN Guidelines recommend starting screening earlier and often include breast MRI in addition to mammography.”¹

Although nothing can eliminate the risk of breast cancer entirely, eating a balanced diet, maintaining a healthy weight, limiting alcohol consumption, not smoking, and regular exercise are steps that can lower one’s risk.²

“These guidelines will help so many people,” Sue Friedman, DVM, executive director of Facing Our Risk of Cancer Empowered, said in the press release. “There is general confusion about breast cancer screening guidelines and what screenings people should follow based on their risk. NCCN patient guidelines are an easy way for people to access up-to-date expert recommendations in plain language.”¹

References

• NCCN publishes new patient guidelines for breast cancer screening and diagnosis emphasizing annual mammograms for all average-risk women over 40. EurekAlert!. July 27, 2022. Accessed July 27, 2022. https://www.eurekalert.org/news-releases/960024
• Breast Cancer Facts and Statistics. BreastCancer.Org. Last Updated July 14, 2022. Accessed on July 27, 2022. https://www.breastcancer.org/facts-statistics